Addicts are 'powerless' over alcohol and other drugs

Story and Pix by David Ogot © 2003

Teresa Ngigi, Programme Director the Redhill Place Treatment Center
As prisons commanders, "you come into contact with drug users, abusers and mis-users" all of whom you treat as criminals where as "at Redhill our approach is to treat them as patients not criminals or mad people."

This was the introduction to a presentation given by Ms. Teresa Ngigi Programme Director of the Redhill Place, a chemical dependency rehabilitation center in Tigoni just outside Nairobi. Ms. Ngigi was addressing prisons commandants drawn from all over Kenya in a workshop whose aim was to empower and better sensitise these officers on the types of drugs, their effects and the rehabilitation process of inmates as well as how to handle them. The workshop was organised by the National Agency for the Campaign Against Drug Abuse (NACADA) in collaboration with the office of the Commisioner of Prisons at the Kenya Insitute of Adminstration.

Usually by the time an addict got to a rehabiltation center, all areas of their lives have been totally fragmented and therefore it was only a holistic approach which covered all these areas, e.g. physical, social, spiritual and mental that would be most effective.

At the same time she went on "we give drug free treatment for we believe that if you treat the addiction with drugs, you are merely replacing one drug with another."

Giving the example of other countries such as the United Kingdom, the Redhill Director revealed that they had several programmes and did not treat individuals for as long as we did in Kenya as in-patients. They had programmes such as the Alcoholics Annonymous (AA) and numerous other support organisations which dealt with different parts of an alcoholics or other addicts disease. If there were mental problems like depression these were dealt with by psychiatrists. Physical problems by doctors etc. so that the whole person was treated. I.e the holistic approach.

Yet in other countries like Italy, they did not believe in the AA system but had alcoholic clubs in wht had been dubbed a "social ecological approach" where the group consisted of the addict, memebers of his family and a qualified councellor to guide them through the recovery process. These sessions were started around 1979.

"Addiction is an intricate and complex issue" - Ngigi
Turning back to Kenya Ms. Ngigi informed the audience that addiction "is an intricate and complex issue. I don't pretend to have all the answers and nobody can pretend to but for an addict to get to (the point) where they are hooked is a process (yet) one of the biggest mistakes people make is that if they don't use every day feel they are not addicted. You hear people saying 'I only use once in a while, I'm not hooked, I can stop anytime I want.' Thus even a person who abstains for a year can still be an addict as addiction is not a matter of frequency and quantity."

Addiction was about powerlessness and once an alcoholic for example put alcohol in their mouths, they lost control. The fact that maybe they had not drunk for a week would not be the issue. "The issue is what happens to this mans (womans) brain and his body chemistry when he takes alcohol. Thus before you know how to handle an addict, you have to know how it (addiction) works, how to recognise certain symptoms."

"When an addict or alcoholic comes for treatment, this person is already fragmented and the first thing you notice in an addict is denial which is part of the disease. denial is whereby somebody doen't think they have the problem while the whole world can see that they have it." Furthermore they blame others for all their woes which is in itself also part of the disease. There is an element of insanity to addiction where somebody keeps reaching for their drug of abuse while it is the one ruining their minds. This person has become heavily obsessed and will do anything including robbing or conning to get.

'Addicts are powerless.' Prisons commanders listen keenly
Teresa Ngigi explained why it was futile to think or tell an addict to 'just stop'thus: "you get people telling them to stop this but how? They are powerless! yet we treat them as criminals, mad people hopeless, but they are not. They are sick people."

Therefore as with all other sick people, you don't condemn, but instead do the logical thing and take them to a hospital. "If you have a diabetic, you don't say 'you bloody diabetic why aren't you taking your medicine'. But what if the diabetic refuses to take their medicine? That's when the troble starts." She stressed that with addiction one was dealing with a disease which brought so many problems and not the other way round. It was so serious that not even geographic or environmental relocation would make a difference. hence you could pick an addict out of "Kibera and put in Riruta" and they would still look for their drug of choice.

Addiction as has been mentioned earlier was a process and Ms. Ngigi now proceeded to explain it in more detail starting with the fact that it occurred in three main stages namely

Yet the funny thing was that in the "early stages you function better when using the drug, apparently. This happens to people and they feel 'wow' where has this been all my life? When you use the first time you feel so euphoric that for the rest of the time you use you will strive to get this high¹"

It is also during the early stages that there are not so many consequences associated with drug use apart from this improved functioning and this then is the greatest illusion which is compounded by the fact that at this point you also do not have to use daily. However when you do use you get an elevated sence of self esteem (false) and you feel as if you fit everywhere.

Then the preoccuapation with using starts and this is one of the first signs that you are moving to the middle stage. It is at this stage too that "you start using in order to cope with life's problems. This is proof that you are moving on to the middle stage."

Around this period too one starts to experience withdrawal symptoms and paradoxically you might not even be drinking daily. Possibly you are still drinking only on weekends "but then you will drink from Friday to Sunday. Then on Monday, withdrwal hangi (hangover), some shaking, tremors, maybe some sweating etc." These early withdrawal symptoms might not be so severe at this juncture. For example someone on heroin might just brush it off with mimi na ji kuna-kuna kidogo (I'm just slightly itchy). But it is at this stage where your personality also starts to disintegrate into a pseudo-personality or one where you values and standards, ideals and spirituality are based on dubious standards. You start lying, covering up, conning stealing and experience shifting values. This was the general trend though no two addicts were ever the same.

The Middle Stage was where those addicts who were lucky, sought help for "here 50 - 60% can be helped as opposed to the early stage where about 80% could be helped. If the disease at this stage was not arrested, you graduated (to next stage) as obsession takes a deeper and deeper grip."

Finally you have entered the Late Stage and it is here that you proceed to sink deeper and deeper into denial. If you do not suceed in breaking through chances are that you will become a mental case.

When one was in the Late Stage, there were only three choices left. These were

  1. Break through your denial and live a life of abstinence from alcohol or other drugs and so gradually bring your life back on track,
  2. Insanity brought about by prolonged use of alcohol and other drugs or,
  3. Death which could come in a myriad of ways like physical e.g. liver ciroshis, heart-failures, ulcers,cancers, kidney failure or death by misadventure e.g. being fatally knocked down by a car, stabbed in a fight, etc. But the main one nowadays would be death by HIV/AIDS. Either by the sharing of dirty, infected needles or mainly in the case of alcohol where one has constant casual and unsafe sex as when you are drunk, you reasoning goes out the window and you have sex with people and in situations you would never have dreamed of had you been sober.

'What is rehabilitation?' Prisons officers at the workshops
Having given this brief background on addiction Ngigi now turned to rehabilitation underscoring that she would be speaking on the Redhill Place method which was a drug-free method. "When we say drug free, does not mean we don't use drugs for example when you are sick maybe you have liver cirhosis. Drug -free means not using any drug to supplement" the one you have been using. E.g largactil or morphine. If you have medical needs e.g blood preassure, liver or heart problems we treat the medical aspect.

By rehabilitation we mean "putting the person back on track to where they were before they messed up. Treating this person as criminal will not help. You would only be dealing with one aspect of the problem. (When) you lock them up what happens to their heart, head, spirituality etc? Or you sit them down and pray to cast out demons. When the demons go what do you replace them with?"

Many times we in addiction we only ended up treating the symptoms and not the disease. It was imperative therefore with alcoholism and other drug addictions one needed to "focus on the disease and in a holistic manner.

There was also a need to understand that the disease was progressive and one could never go back to using. "Once an addict, always an addict!" Ngigi warned. The reason for this was that any amount of the drug of choice would trigger powerful cravings. That was also the reason there was urgent need for aftercare programmes.

¹This does not happen to everybody. Many people have very bad reactions to alcohol and other drugs the first time they try them. In fact some are never able to even continue say drinking alcohol. Evidence abounds a suggesting that for many who however feel extremely euphoric the first time they try a drug, it should act as a red flag for potential future problems or addiction.

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